Provider Demographics
NPI:1376784744
Name:EHRIN PARKER DO PA
Entity Type:Organization
Organization Name:EHRIN PARKER DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EHRIN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-310-7177
Mailing Address - Street 1:505 E PALM VALLEY BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3043
Mailing Address - Country:US
Mailing Address - Phone:512-310-7177
Mailing Address - Fax:512-246-0045
Practice Address - Street 1:505 E PALM VALLEY BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3041
Practice Address - Country:US
Practice Address - Phone:512-310-7177
Practice Address - Fax:512-246-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4980204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG99777Medicare UPIN